Ito Mitsugu, Takahashi Naoto, Saitoh Hirobumi, Shida Seiji, Nagao Takayo, Kume Masaaki, Kameoka Yoshihiro, Tagawa Hiroyuki, Fujishima Naohito, Hirokawa Makoto, Tazawa Hiroshi, Minato Takashi, Yamada Shin, Sawada Kenichi
Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan.
Intern Med. 2011;50(19):2213-7. doi: 10.2169/internalmedicine.50.5829. Epub 2011 Oct 1.
We report a 47-year-old man with acute leukemia who survived a severe case of necrotizing fasciitis caused by Clostridium perfringens involving his right upper extremity. On day 5 after stem cell transplantation, progressive local tissue necrosis led to septicemia and disseminated intravascular coagulation. Early diagnosis and prompt initiation of appropriate therapy, including surgical debridement and broad-spectrum antibiotics, were crucial. A recombinant thrombomodulin might have not only resolved the coagulation problem but also prevented multiple organ failure associated with the systemic inflammatory response.
我们报告了一名47岁的急性白血病男性患者，他在遭受由产气荚膜梭菌引起的累及右上肢的严重坏死性筋膜炎后存活下来。在干细胞移植后的第5天，进行性局部组织坏死导致败血症和弥散性血管内凝血。早期诊断并迅速开始适当的治疗，包括手术清创和广谱抗生素治疗，至关重要。重组血栓调节蛋白可能不仅解决了凝血问题，还预防了与全身炎症反应相关的多器官功能衰竭。
